Summary:

Born in 1921 in Belarus (White Russia), the author lost his father (a doctor) as a baby and was raised by his mother who worked as a surgical nurse and midwife. He excelled in school and was on the verge of entering medical school, but the political upheaval of World War II drew him away from studies.
 
Drafted to serve in the Polish army, the eighteen year-old became a sergeant in charge of a platoon by June 1939 fighting against Germany along its border with Poland. Three months later he was captured and imprisoned in cruel conditions. By November, he escaped and began a long walk home, helped by strangers, only to find that the Soviets had taken over. Arrested again, this time for being anti-Communist, he spent January to June 1941 in a Soviet prison, and narrowly avoided execution when the Russians retreated at the German invasion of Minsk. Another return home was met with the tragic news that his mother had been killed when German bombs hit the hospital in which she worked.

Enraged by the succession of destructive invaders, Ragula helped create a nationalist freedom army, the Eskradon, ironically with German support, and a Bulletin to inform citizens and lobby for better conditions. By the time World War II drew to an end he was married to Ludmila (in 1944) and on the move, seeking a medical education.

As refugees, the couple moved to Marburg, Germany in 1945, where Ragula began medical school. But money was always a problem and the post-war restructuring of Europe made them fearful. Hearing of a program for refugees in Louvain, Boris entered Belgium illegally in 1949 and finally completed his medical degree in 1951 at age thirty-one. In 1954, the couple settled in the medium-sized town of London Ontario, Canada. There Ragula interned and set up a family practice. He and Ludmila raised their family of four in peaceful security that contrasted starkly with their own upbringing.

Precocious in promoting health, Ragula campaigned tirelessly against smoking, inactivity, and overeating, and he worked in aboriginal communities, convinced that a doctor's role was to prevent disease as much as it was to treat it.  Here too he found enemies and friends.
 
In 1963, Ragula was involved in a non-related kidney donation between patients-a selfless act that touched him deeply. For him, it represented the pinnacle of scientific achievement and epitomized how humans should care for one another.

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Thirteen-year-old Matilda lives on a south Pacific island with copper mines. Rebels and other more official warriors are tearing the place apart. A blockade has made resources scarce and communication impossible; fathers are absent at distant work. Along with everything else, the local school collapses. 

Mr. Watts, the only island white man, offers to take over the education of the children, but he has no experience, few materials and just one book: his treasured copy of Charles Dickens’s Great Expectations. He begins reading a few pages every day. Captivated by the story, the children repeat it to their mothers when they go home each night.  

Matilda believes that she loves Mr. Dickens more than anyone else and she is both bemused and irritated by her stern mother's suspicion of the strange, possibly godless, white man and her feigned disinterest in Pip. Parents are invited to the school to pass on their own expectations about learning. Students accept these moments with pride and embarrassment.

The political chaos deepens, homes are destroyed, and the book vanishes. But Watts (nicknamed Mr. Pip) turns the loss to advantage by helping the students to recover fragments in a lengthy effort of collective recollection.

The ever menacing warriors return. Little more than frightened children in an incomprehensible conflict, they indulge in senseless brutality and killing. With courage absorbed from her mother, Matilda escapes, rediscovers her father, and finds a scholarly future—a life she embraces because of Mr. Dickens and Mr. Pip.

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Medicine and religion cross paths in the examination of miracles and the canonization process of Roman Catholic saints. The author of this book, a medical historian and hematologist, compiles an impressive amount of data procured largely from four trips to the Vatican Secret Archives. She reviews 1,400 miracles from the time period 1588 to 1999 and discovers that 95% of these phenomena involve the healing of a physical illness. The author scrutinizes the nature of these miracles and investigates the dynamics and beneficiaries of them.

Medical expertise plays a central role in the substantiation of miracles. After all, miracles that involve healing imply a failure of medical treatment. Over the centuries, any physician providing testimony about the occurrence of a possible miracle must address two issues. The doctor must confirm the hopelessness of a patient's prognosis. The doctor must admit that the positive outcome of the case is nothing short of astonishing. The text is adorned by some splendid and strange paintings that illustrate people requesting or receiving miracles. It profiles celebrities in the history of the canonization process such as Prospero Lambertini (Pope Benedict XIV) and Paolo Zacchia.

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This collection of stories offers a sidelong view of medicine from the perspective of a thoughtful, experienced doctor of internal medicine at a teaching institution (UCSF) in an urban setting that brings a wide variety of types of patients to his door.  In a context of evident respect and admiration for even the quirkiest of them, Watts admits to the kinds of personal responses most have been trained to hide-laughter, anger, bewilderment, frustration, empathetic sorrow.  The cases he recounts include several whose inexplicabilities ultimately require action based as much on intuition as on science.  He includes several stories of illness among his own family and friends, and makes it clear in others how his professional decisions affect his home life and his own state of mind.  

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Triggered in part by a trip to the Galápagos Islands, the author interweaves two parallel narratives: Darwin's "journey toward evolution" along with the related work of Alfred Russel Wallace; and the author's own journey through life, partially disabled and dependent on the specially fitted shoes that help him to walk.  Together these two narratives develop "all I have come to understand about chance and change, fear and transformation, variation and cultural context, ideas about the body that question the definition and existence of difference in all of our lives" (xvii).

Born with an unnamed congenital condition in which his fibulae are absent along with other lower limb "abnormalities," Fries underwent five major reconstructive surgeries as a child, but after those, what helped him most were special shoes that were fitted to his special body, assisting him to walk.  As an adult, however, he begins to experience back pain and knee problems.  The memoir relates, both in flashback, and in the present day, Fries's quest for a proper pair of shoes that will help him avoid yet another surgery -- the shoes he has been wearing are 20 years old and no longer do the job.  We meet Dr. Mendotti, who treated him like a peculiar specimen and offered a pharmacologic way out of his pain; shoemaker Eneslow, in a dingy Union Square office, whose shoes not only fit Fries well, but were festive in appearance -- "I felt both normal and special" (17); other practitioners of orthotics who try but fail to construct shoes that relieve Fries's pain, and finally, the gifted, patient orthoticist, Tom Coburn, who persists until he is able to provide shoes that work.  The shoes have been adapted for Fries's body, just as man has constructed adaptations that allow him to live in a variety of climates and circumstances.  Conversely, Fries, convinced he "can adapt to the circumstances in which my body places me (169)," draws from Darwin, whom he quotes: "individual differences are highly important for us, as they afford materials for natural selection to accumulate" (169).
 
Darwinian connections are invoked throughout the narrative.  The peculiar configuration of Fries's feet and shoes help him to ascend a series of mountain ladders while his partner, Ian -- who usually has to assist Fries with such physical maneuvers -- suddenly becomes fearful of the height and exposure;  back problems might have developed even without his congenital abnormalities because evolution of the capacity to walk upright included the tendency toward back pain; the role of chance in natural selection and the role of chance in the physical fact of congenital conditions; the positive role that his partner Ian's attention deficit disorder (ADD) could have played in the days of hunter-gatherers and the cultural context in which ADD is now considered to be "abnormal."
 
Fries discusses his fears -- both rational and irrational -- as well as his awareness of stigma, difference, and sameness.  The context of these discussions is usually a reminiscence about vacations in far-flung countries (Thailand, the Galápagos, Bali, Alaska, the Canadian Rockies) and physically challenging domestic locales (a Colorado River raft trip, the Beehive Mountain in Acadia National Park).  He  occasionally brings into the discussion his homosexuality, especially as his physical deformity affected sexual encounters.  The relationship between Fries and Ian is woven throughout the memoir as one of understanding, mutual need and benefit.  As the memoir ends, Fries worries about the likelihood he will need a wheelchair, but is at the same time gathering confidence in his ability to ride the Easy Flyer bicycle that Ian has discovered at the local bike shop.

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At the request of a German editor, Charles Darwin (1809-1882) began his autobiography at the age of 67. His granddaughter and editor, Nora Barlow, tells us that he revised it over several years.

Darwin remembers little about his mother who died when he was 8, but talks at length about his forceful physician father, who measured 6 foot 2 inches, and weighed over 336 pounds. His father's success guaranteed that Charles would never have to work for a living. Darwin was a naughty boy schooled in humaneness and manners by his loving sisters. Early on, he showed a passion for collecting, mostly beetles, but also coins, shells, and minerals. He hated boarding school; he enjoyed running in the open air and shooting snipes with his dogs. He quotes his father's characterization of him as a young boy: "You care for nothing but shooting, dogs, and rat-catching, and you will be a disgrace to yourself and all your family" (28).

As a medical student at Edinburgh University, he witnessed operations without anesthesia which caused him to revolt against his father's wish that he become a doctor; he couldn't take the sight of blood.  At Cambridge, he found most of his classes and professors dull, except for his botany professor, John Stevens Henslow, his mentor and hiking companion. The paternal plan for him to become a clergyman foundered at Cambridge, as Darwin questioned the Thirty-nine Articles of the Church of England.

From 1831, he sailed with Capt. Fitz-Roy on board  The Beagle for 5 years and 3 days (again, against his father's wishes). He quarrelled with  Fitz-Roy whose mood swings required Darwin's tact. They disagreed about slavery, FitzRoy defending it, and Darwin abominating it. He carried Lyell's Principles of Geology with him, read Milton, and collected numerous specimens which he sent back to Britain.

28 months after his return, Darwin married his cousin, Emma Wedgwood. The marriage was happy and produced 10 children.

In the chapter on his religious beliefs, Darwin gives 4 reasons for believing the Old Testament to be false; as he has studied the laws of nature, he has ceased to believe in miracles. He rejects Bishop Paley's argument for intelligent design: "Everything in nature is the result of fixed laws" (87). The Christian god is cruel, as he causes innocent animals to suffer and condemns non-believers to hell. Darwin confesses he does not understand "the mystery of the beginning of all things" (94), calling himself an agnostic. He outlines the great Victorian men he has known, though his ill health has long  prevented him from traveling or seeing friends. He discusses his publications, including Origin of Species, stating he did not care whether he or Wallace got the credit for the theory of evolution. He attributes his success to his moderate abilities. He has been methodical, industrious, and commonsensical.

The appendix includes Darwin's list of pro and con arguments about marriage, Mrs. Darwin's papers on religion, and a short chapter on his illnesses.

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John Romulus (also known as Richard) Brinkley was a physician (in the diploma-mill sense of the word) who, in 1917, pioneered, in the U.S. at least, the notion of goat testicle transplant. "Transplant" must be understood in the loosest sense of the word since Brinkley simply removed the testicles from young goats and sewed them into the abdominal wall and scrotal tissues - without any attempt to connect blood or nervous tissues of either goat testicles or human  - of men for the alleged purpose of relieving impotence. From 1917 until his downfall at the hands of Morris Fishbein, a medical crusader esconced in the AMA, which organization Dr. Fishbein helped establish as the premier advocate of organized medicine in the U.S., Dr. Brinkley was perhaps the most recognizable physician in the U.S.

He ran for the office of Governor of Kansas in 1930 (losing by technicalities that today would have overturned the results), and established the most powerful radio station in the land, XERA, that promulgated his glandular chicanery all across the continental U.S. As a proponent of such skullduggery, Brinkley was continually in the sights of Dr. Fishbein, whose main reputation nationally was as an exposer of medical fakery. Eventually Fishbein lured Brinkley into a libel trial that resulted, in 1939, in the catastrophic downfall of an immensely talented and wealthy man who spiraled into bankruptcy and death in 3 short years.

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Kaplan Publishing has recently released several anthologies aimed at a nursing audience or perhaps at a reading audience that wants to know more about what nurses think and feel about their professions.  This anthology, a collection of poetry and essays, looks at the various reasons these authors went into nursing in the first place, how nursing changed them, and why they either stayed the course or went on to other pursuits.  As the editors say in the Introduction, "nursing abounds with experiences that can either reinforce our vocational commitment or cause us to reconsider it" (p. xi).

In the first section, "The Calling," poems and essays examine "the idealistic reflections of those aglow with nursing's promise of intimacy and connection" (xii).  Here we meet student nurses with a true calling who are "living, breathing and sleeping nursing" (p.5), and students who are sure they are going "to murder someone" (p. 6).  Like most professionals, nurses often have mentors, and those mentors--"brisk, frank, fast, sometimes sharp" (p. 30)---are honored in this section as well.  Readers, upon completing this section, will be moved and cheered by the poems and essays that reflect the romance of nursing and the intense drive that many nurses have to give of themselves to others. 

The editors, however, are no Polyannas.  They know that a student's illusions and dreams will run right smack into reality.  While the rewards will certainly be many, the discouragements will be present as well.  The fact that both experiences---the highs and the lows---can occur within a single day is reflected in the collection's second section, "The Reckoning."  Here the realities of death, exhaustion, burnout and doubt are faced full on.  Some of the works in this section are by nurses who have chosen to leave the profession:  "Brazil, the new hospital.  We have no water.  Doctors protest poor facilities by refusing to see patients and sitting in their cars outside in the parking lot" (p. 81), writes Veneta Masson as she traces her career from 1958 to 1998 when she decides to leave nursing and "use my hands to write and to bless" (p. 84).  While some have chosen to leave, other nurses have found ways to survive: "Nursing allowed me to help my mother die; my music has helped me live" (p. 88) writes Colleen O'Brien, and Fr. Robert J. Kus writes about his dual roles, priest and nurse, how they balance and enhance one another (pp. 102-110).  The works in this section remind readers of the sacrifices caregivers must make every day.  As Jo Ann Papich writes, "Please appreciate your nurse while you still have one" (p. 99).

Section Three, "Reincarnation," tells of the "informed commitment that arises after sustained trial" (p. 165).  Here nurse-writers talk about survival and the oddly comfortable balance between stress and transcendence that comes, at last, after many years in nursing.  In "Why I Like Dead People," Sallie Tisdale takes a wry look at death, nursing homes and their "cockeyed logic" (p. 175).  Anne Webster, in "Slow Night in the E.R." talks about doing what you must do to help others even when you "can't do it," when you "stand outside the curtain, shaking" until the patient asks, "Are you there?" (p. 186-7).  Kathryn Gahl, in "The Reason Nurses Write Mostly Poetry" says it's because nurses "convert heart sounds // and hard words into art before the next patient / arrives, hemorrhaging, counting on that nurse / to flow like a pen, bleed for both of them" (p. 195).  And in the book's final essay, "I'm Staying," Shirley Stephenson offers a series of lovely statements about why she, and others, might continue in the frustrating, tiring, challenging and miraculous profession of nursing.  "Because I have been in the bed, and beside the bed. Because I have waited. Because I believe any one of us could face the circumstances of those for whom we provide care, and we're much more similar than different. Because this is where the rhythm is loudest---yes this yes this yes this yes this" (p. 246).

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Mabry Kincaid, a New York art conservator is flying home on September 11, 2001, when news comes to him on the plane of the attacks on the World Trade Center.  Unable to return to his apartment in the city, he decides to visit his aging father, an Episcopal priest, in his boyhood home in North Carolina. There he meets Audrey, an African-American seminary student in her forties, who has moved in to care for his disabled father.  In the ensuing weeks Mabry is led to reflect deeply not only on the fate of the country and of his career, but on how his father's apparently final illness compels him to come to new terms with their constrained relationship. The death of the brother Mabry always believed to be the favorite has left a painful chasm between father and son, made more so by his father's own admission of favoritism.

At the same time Mabry is coming to terms with his own diagnosis of multiple sclerosis and with the grief he continues to process since his wife's death from cancer.  Audrey and her son bring a new dimension to the life of the household and a widened sense of family to the two men as they struggle to lay the past to rest and to accept the radical uncertainties of the personal and national future. One interesting subplot involves Mabry's discovery of what is reputed to be a minor, uncatalogued Van Gogh painting, covered by the work of another artist, that he has brought home for his employer, now dead, and his musings about what to do with this undocumented treasure.  The question remains open for symbolic reflection as he leaves it behind in North Carolina and returns to New York for a very different kind of life than the one he left. 

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Filmed at Shands (teaching) Hospital in Florida, this documentary validates the importance of the arts and expressive therapies in all aspects of health care, including medical education. Pediatric oncologist John Graham-Pole and poetry therapist John Fox -often as a team- work with patients of all ages in groups and at the bedside.   Other physicians including a neuroscientist provide rational explanations of the release of endorphins and brain changes resulting from creative activities.  Though the healing process initiated by the reflective act of writing poetry is ostensibly the focus of the film, the documentary is permeated with the transforming effects of dance and art therapies in their ability to lessen physical and emotional pain; the importance of healing environments, not just paintings in lobbies, but in patient created ceiling tiles and wall installations; and especially the warmth, intimacy and humanity generated by exemplary physician communication skills.

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